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Kim, Won-Keun; Schäfer, Ulrich; Tchetche, Didier; Nef, Holger; Arnold, Martin; Avanzas, Pablo; Rudolph, Tanja; Scholtz, Smita; Barbanti, Marco; Kempfert, Jörg; Mangieri, Antonio; Lauten, Alexander; Frerker, Christian; Yoon, Sung-Han; Holzamer, Andreas; Praz, Fabien; De Backer, Ole; Toggweiler, Stefan; Blumenstein, Johannes; Purita, Paola; Tarantini, Giuseppe; Thilo, Christian; Wolf, Alexander; Husser, Oliver; [...]

Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)

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  • Medientyp: E-Artikel
  • Titel: Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)
  • Beteiligte: Kim, Won-Keun; Schäfer, Ulrich; Tchetche, Didier; Nef, Holger; Arnold, Martin; Avanzas, Pablo; Rudolph, Tanja; Scholtz, Smita; Barbanti, Marco; Kempfert, Jörg; Mangieri, Antonio; Lauten, Alexander; Frerker, Christian; Yoon, Sung-Han; Holzamer, Andreas; Praz, Fabien; De Backer, Ole; Toggweiler, Stefan; Blumenstein, Johannes; Purita, Paola; Tarantini, Giuseppe; Thilo, Christian; Wolf, Alexander; Husser, Oliver; [...]
  • Erschienen: Oxford University Press (OUP), 2019
  • Erschienen in: European Heart Journal, 40 (2019) 38, Seite 3156-3165
  • Sprache: Englisch
  • DOI: 10.1093/eurheartj/ehz429
  • ISSN: 0195-668X; 1522-9645
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 ± 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P &amp;lt; 0.001) and after 1 year (30.5% vs. 16.6%; P &amp;lt; 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P &amp;lt; 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.</jats:p> <jats:p /> </jats:sec>
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